Vascular Ehlers Danlos syndrome is a rare connective tissue disease that is associated with various arterial complications.
A 25 year old man with vascular Ehlers Danlos syndrome presented with acute lower back pain as a result of a ruptured aneurysm of the median sacral artery (MSA). Prior medical history included several vascular events resulting in a right iliac occlusion. The unusual location of aneurysmal disease of the MSA might be explained by extensive collateral flow recruitment due to this occlusion.
Previous vascular events inducing collateral recruitment might justify a more frequent follow up in patients with connective tissue disorders.
Previous vascular events inducing collateral recruitment might justify a more frequent follow up in patients with connective tissue disorders.The combination of endovenous therapies with stab avulsion or ultrasound guided foam sclerotherapy is widely performed. However, these conventional techniques tend to result in incomplete avulsions or persistent varicosities.
One hundred and thirteen legs in 97 consecutive patients who underwent 1470 nm laser ablation for great saphenous varicose veins were enrolled. The foam sclerosing agent was injected via the sheath after endovenous laser ablation (EVLA). Patients were divided into two groups EVLA only group (Control; = 50) and EVLA and transluminal injection of foam sclerotherapy (TLFS) group (SCL; = 63).
At three month follow up, reflux was abolished throughout all treated great saphenous veins (GSVs) when assessed with Duplex ultrasound. Thrombophlebitis was observed in two patients in the SCL group (= .13). Additional second stage sclerotherapy was needed in the Control group (= 33, 66%) SCL group (= 2, 3%; &lt; .0001). The venous clinical severity score (VCSS) was significantly improved in the SCL group (changes of VCSS, Control-3.3 ± 1.7 and SCL -4.4 ± 1.0; &lt; .0001). Univariable and multivariable analyses revealed that, among age, sex, Clinical-Etiology-Anatomy-Pathophysiology classification, linear endovenous energy density, and TLFS, TLFS was the only significant factor of improved VCSS (hazard ratio=-0.96; 95% confidence interval=-1.4 to-0.58; &lt; .0001).
TLFS combined with EVLA may be an easy, safe, and effective procedure with acceptable complications EVLA alone and reduces additional second stage interventions.
TLFS combined with EVLA may be an easy, safe, and effective procedure with acceptable complications vs. EVLA alone and reduces additional second stage interventions.Strain gauge plethysmography (SGP) is employed to evaluate venous drainage of the lower leg.
In this study, SGP was used to evaluate the effects of the hydrostatic pressure (HP) of water on venous volume (VV), expelled volume, and ejection fraction (EF) in 22 healthy legs before and during immersion in water.
HP reduced VV by 100% and even more during underwater (UW) exercise, making calculation of the UW EF possible.
UW SGP is feasible and indicates that HP improves venous haemodynamics. This study suggests that including UW leg exercise in the rehabilitation protocols of patients with chronic venous disease may be useful.
Strain gauge plethysmography, Underwater compression, Underwater ejection fraction, Underwater venous volume.
Strain gauge plethysmography, Underwater compression, Underwater ejection fraction, Underwater venous volume.Common femoral artery aneurysm is a rare condition and can be treated by open or endovascular surgery. There is a general understanding that open surgery is the recommended option because of the anatomical location and the biomechanical constraints posed by hip flexion.
The case of a 66 year old man treated with an endograft for an asymptomatic abdominal aortic aneurysm followed by the implantation of a nitinol covered stent graft (Fluency™, Bard Peripheral Vascular, Temple, AZ) for a 25 mm diameter left common femoral artery aneurysm is reported. Two years later, follow up revealed a rupture of the nitinol covered stent graft, requiring an open iliofemoral reconstruction.
Systematic analysis with protocolised cleaning, and macroscopic and microscopic evaluation (Keyence VHX-600 digital microscope) of the explanted nitinol covered stent graft showed membrane perforation at the level of an acute angle formed by the struts.
Systematic analysis with protocolised cleaning, and macroscopic and microscopic evaluation (Keyence VHX-600 digital microscope) of the explanted nitinol covered stent graft showed membrane perforation at the level of an acute angle formed by the struts.Congenital left inferior vena cava (IVC) with hemiazygos continuation and drainage into the superior vena cava (SVC) is a rare IVC variant and is associated with venous thrombo-embolism. This is the report of a case of hemiazygos continuation of the left IVC receiving catheter directed thrombolysis (CDT) for pulmonary embolism.
A 72 year old woman presented with progressive dyspnoea, and CT images confirmed the diagnosis of pulmonary embolism. The unusual route of the IVC was observed during the right heart catherisation and CDT. CDT was then performed with a left femoral venous approach. The patient tolerated the procedure well, and the follow up pulmonary angiogram showed no residual thrombus.
The use of CDT for pulmonary embolism in patients with left IVC with hemiazygos continuation and drainage into the SVC has been reported rarely. Awareness of this diagnosis is critical during right heart catheterisation to prevent devastating complications. However, with careful manipulation, right heart catheterisation and CDT can be achieved successfully. Pulmonary embolism in patients with left IVC with hemiazygos continuation and drainage into the SVC can be treated with CDT safely and effectively with caution. It is wise to remember the different anatomical variations during IVC catheterisation.
The use of CDT for pulmonary embolism in patients with left IVC with hemiazygos continuation and drainage into the SVC has been reported rarely. Awareness of this diagnosis is critical during right heart catheterisation to prevent devastating complications. https://www.selleckchem.com/products/17-AAG(Geldanamycin).html However, with careful manipulation, right heart catheterisation and CDT can be achieved successfully. Pulmonary embolism in patients with left IVC with hemiazygos continuation and drainage into the SVC can be treated with CDT safely and effectively with caution. It is wise to remember the different anatomical variations during IVC catheterisation.